Organization
LEISURE WORLD OF MARYLAND, CORP.
Active
Other names
Leisure World Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA BRONAUGH (ADMINISTRATOR)
(301) 598-1550
Entity
Organization
Contact information
Practice address
3305 N LEISURE WORLD BLVD, SILVER SPRING, MD 20906-1367
(301) 598-1590
(301) 598-1569
Mailing address
3305 N LEISURE WORLD BLVD, SILVER SPRING, MD 20906-1367
(301) 598-1590
(301) 598-1569
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B773
BLUECROSS/BLUE SHIELD
—
01
—
CA5483
RAILROAD MEDICARE
—
Enumeration date
06/30/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us